Localization procedures in patients requiring reoperation for hyperparathyroidism.
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Adenoma↗
Biomedical subjects
A A Moss
Publications and source records attributed to A A Moss.
Computed tomographic diagnosis of complications of transhepatic cholangiography and percutaneous biliary drainage.
Over a 12-month period we evaluated, using computed tomography, 11 patients suspected of having developed complications of biliary interventional procedures. CT scans revealed 3 hepatic abscesses, 3 intrahepatic or subcapsular hematomas, 3 bilomas, of which 2 were infected, 1 pancreatic abscess, and 1 case of extension of tumor along a biliary catheter tract. Computed tomography provided information which allowed very specific preoperative diagnoses and which guided plans for further evaluation and treatment.
Abscess↗
Ultrasonic characteristics of frozen liver.
The recent development of new ultrasound probes has made real-time intraoperative monitoring of cryosurgery, and thermocouple placement a possibility. It is shown that frozen tissue and thermocouple needles have acoustic characteristics that enable them to be easily visualized by ultrasound examination. Further in vivo animal studies are needed to examine temperature characteristics of visualized cryolesions, to develop scanning techniques, and to correlate ultrasonic findings with histologic changes in tissue.
Animals↗
Quantification of body fat distribution in the abdomen using computed tomography.
A computed tomographic method was used to assess the pattern of abdominal fat distribution in normal males and females at different abdominal levels. The method permitted site specific calculations of total body volume (TA), total fat volume (TF), subcutaneous fat volume (SF), and intraabdominal fat volume (IF) in each computed tomography scan. The ratio of TF/TA, SF/TF and IF/TF were calculated for the L1, L3, and L5 vertebral levels. Regression analysis of IF versus SF, SF versus TF, IF versus TF, TF versus TA, and TF versus body mass index and age were calculated. A significant linear correlation between the measured variables TA, SF, IF, and TF and between TF and body mass index was found for virtually all correlations attempted at all scanned levels. Females had a higher total fat volume and greater percentage of subcutaneous fat at all levels. Males accumulated more fat intraabdominally than subcutaneously at the L1 and L3 levels. The male-female differences were greatest at L1 and the ratio SF/IF statistically significant at the L1 and L5 levels. Our results demonstrate that computed tomography can noninvasively quantify abdominal fat distribution at various sites. There is an inherent difference in abdominal fat distribution between males and females that is not related to weight. The distribution of body fat in males and females varies markedly from level to level.
Adipose Tissue↗
Computed tomography of visceral infarction due to coagulopathy.
The computed tomographic (CT) appearance of pancreatic infarction has not been described previously. We report a case in which pancreatic infarction associated with multiple visceral infarcts was detected by CT. In addition, CT revealed extensive, progressive arterial and venous thrombosis due to the patient's known deficiency of antithrombin III.
Antithrombin III Deficiency↗
Computed tomography of malignant carcinoid disease.
Twenty-two patients with malignant carcinoid syndrome were evaluated with CT, the largest series to date. A mass representing the primary tumor or local adenopathy was identified in four patients, appearing as a homogeneous mass involving mesentery and bowel. In two other patients the primary was not identifiable by barium series, angiography, CT, or laparotomy. In the remaining 16 patients who were scanned after resection of the primary four had mesenteric thickening and five had adenopathy. Malignant ascites was present in seven of 21 patients. All hepatic metastases were hypodense on the precontrast study. The effect of contrast administration on lesion detectability was variable, obscuring at least one or more metastases in eight of 21 scans. We recommend noncontrast scans of the liver in patients in whom the number and size of metastases are critical to therapy.
Contrast Media↗
Computed tomography of ileal loop urinary diversion in adults.
Surgically-placed urinary conduits remain the most common form of long-term, supravesical urinary drainage. We reviewed CT scans of 16 patients with ileal loops examined during a 3-year period to assess normal loop anatomy and associated pathological conditions. Computed tomography was indicated when conventional studies were considered inadequate. Indications for studies were suspected tumor recurrence in 12 (75%) and abscess localization in four (25%). The normal CT ileal loop lies medial to the cecum at the level of the sacral promontory. In 12 patients, CT identified abnormalities related to ileal loop diversion. Clinically unsuspected nontumorous complications (xanthogranulomatous pyelonephritis, pelvic abscess, and peristomal hernia) were detected by CT in patients with suspected tumor recurrence.
Abscess↗
Computed tomography of gestational trophoblastic disease.
Twenty-two patients with gestational trophoblastic neoplasia (GTN) were examined by CT of the abdomen and pelvis to assess the usefulness of CT in the detection and staging of GTN. The most common manifestations of GTN by CT were an enlarged uterus in 16 of 20 patients (80%) with bilateral adnexal cysts in 12 of 22 patients (54%). Contrast enhancement of the uterus was inhomogeneous and the cysts were usually unilocular, ranging in size from 1.0 to 6.0 cm. Metastases were found in 13 of 22 cases (59%). Local extension into the broad ligament was present in 5 of 22 cases (23%). Pelvic or periaortic adenopathy or both was not present. Only one patient had liver metastases. We conclude that CT is a valuable tool in the evaluation of patients with GTN.
Adnexal Diseases↗
Incidence and significance of a widened esophageal hiatus at CT scan.
We studied the anatomy of the esophageal hiatus using axial CT scans in 320 patients. Normally, the diaphragmatic crura are tightly opposed and closely related to the esophagus. Widening of the esophageal hiatus is readily demonstrated by CT as a separation of the diaphragmatic crura and an increased distance between the crura and esophageal wall. The incidence of widening increases with age, lending support to the hypothesis that the abnormality is acquired. In 100 patients who also had barium studies of the upper gastrointestinal tract, a sliding hiatus hernia was found in 37/43 (86.4%) patients who had a widened esophageal hiatus shown by CT. In 26 of 37 (70.2%) patients, the hernia was demonstrated on CT as a pseudomass usually filled with contrast material lying within and/or above the esophageal hiatus. Small hiatus hernias were shown without a widened esophageal hiatus in only two patients.
Adolescent↗
Hepatic tumors: magnetic resonance and CT appearance.
The magnetic resonance (MR) features of primary and metastatic hepatic tumors were analyzed and compared with CT findings in 28 patients. MR images were obtained on a 0.35-Tesla superconducting magnet using a variety of spin echo and inversion recovery imaging techniques. The normal liver appeared homogeneous and of moderate intensity. Tumors typically appeared as masses of increased intensity on spin echo images and diminished intensity on inversion recovery images. Tumors had prolonged T1 and T2 times, which varied in different types of tumors and within regions of a single tumor. A specific T1 and/or T2 time could not be ascribed to any tumor. Tumor intensity varied greatly depending on the imaging techniques employed, becoming isointense with normal liver on some imaging sequences. MR and CT detected lesions equally well, but internal architecture and the relationship of tumors to hepatic vascular structures were better displayed on MR.
Adenoma↗
Chronic liver disease: evaluation by magnetic resonance.
Magnetic resonance (MR) imaging distinguished hepatitis from fatty liver and cirrhosis in a woman with a history of alcohol abuse. Anatomic and physiologic manifestations of portal hypertension were also demonstrated by MR.
Adult↗
Magnetic resonance and CT of the normal and diseased pancreas: a comparative study.
Nineteen patients with proven pancreatic disease and 50 control subjects were examined by magnetic resonance (MR) using a variety of spin echo and inversion recovery techniques. The MR results were then compared with CT scans. The normal pancreatic head, body, and tail were identified by MR in approximately 60% of patients. Pancreatic adenocarcinoma and retroperitoneal lymphoma were detected using morphologic criteria similar to those used in CT. Differentiating bowel from pancreas was difficult on MR in patients with little retroperitoneal fat, and tissue relaxation times were usually not helpful in differentiating adenocarcinoma or lymphoma from normal pancreatic tissue. However, MR intensity, T1, and T2 were useful in differentiating pancreatic islet cell tumors from normal pancreatic tissue. MR accurately identified retroperitoneal invasion, vascular involvement, and liver metastases. In pancreatitis, tissue T1 and T2 relaxation times were prolonged and complications such as ductal dilatation, pseudocyst, phlegmon, and ascites were identified. Small pancreatic calcifications were not detected by MR. Pancreatic iron overload was seen in patients with hemochromatosis. Although respiratory motion and spatial resolution are currently limiting factors, MR is a versatile and unique modality for the evaluation of pancreatic disease.
Adenocarcinoma↗
Renal infarction: CT diagnosis and correlation between CT findings and etiologies.
The CT scans and the clinical records of 12 patients who had renal infarction were reviewed. The renal infarcts were classified as either focal or global. The CT findings were correlated with the etiologies of renal infarction. Embolism was the most common cause of renal infarcts that were multifocal with involvement of both kidneys. Trauma caused a unilateral global type of infarct. A case of sickle cell anemia presented with multiple "slit-like" focal infarcts and enlarged kidneys. Forty-seven per cent of infarcts demonstrated the cortical rim sign, 11% were associated with mass effect, 21% had a subcapsular fluid collection, and 6% had an abnormally thickened renal fascia.
Diagnosis, Differential↗
CT of pancreatic islet cell tumors.
In 41 patients with clinical evidence of pancreatic islet cell tumors, CT detected 21 of 27 tumors that were proved at surgery (sensitivity 78%) and correctly excluded the diagnosis in 14 of 14 patients with no evidence of tumor at long-term follow-up. Using rapid sequence CT scanning and bolus contrast material infusion, a vascular blush was identified in 13 of 16 tumors (81%). Tumors as small as 0.9 cm were localized. CT identified all malignant tumors, and staging accuracy was 100%. CT is useful as the initial imaging procedure for the diagnosis and staging of suspected islet cell tumors. Pancreatic venous sampling and angiography are complementary to CT for the detection of smaller lesions.
Adenoma, Islet Cell↗
Magnetic resonance imaging of the neck. Part I: Normal anatomy.
Magnetic resonance (MR) images of the neck were obtained in 24 patients using a specially designed radio-frequency coil, standard and high-resolution imaging techniques, and a variety of spin echo and inversion recovery pulse sequences. Cervical vascular structures were more easily identified with MR than with CT because of the inherent contrast of flowing blood. The laryngeal skeleton, paralaryngeal tissues, trachea, thyroid, esophagus, and muscles were identified in all cases by MR using morphologic criteria comparable with CT criteria. The spatial resolution of high-resolution MR was slightly inferior to high-resolution CT. However, streak artifacts due to motion and x-ray beam hardening often limited CT, but did not affect MR. Anatomic resolution was best using high-resolution spin echo images obtained with TR = 2.0 seconds and TE = 28 msec because this imaging technique offered excellent contrast between normal tissues and had the highest signal-to-noise ratio. With further improvements in spatial resolution MR is likely to become an important technique for imaging the neck.
Adolescent↗
Magnetic resonance imaging of the neck. Part II: Pathologic findings.
Magnetic resonance (MR) images of the neck were obtained in 14 patients with thyroid, parathyroid, lymph node, or laryngeal lesions. Tumors and lymph nodes were more easily differentiated from muscle and blood vessels with MR than with CT because of the superior soft tissue contrast of MR. Tissue characterization allowed MR differentiation of thyroid nodules, thyroid cysts, and parathyroid tumors from normal thyroid tissue; however, nonspecifically increased T1 and T2 relaxation times overlapped for a variety of neoplastic and inflammatory conditions. Thyroid cyst fluid had the greatest water content and longest T1 and T2 times of all tissues studied. Parathyroid hyperplasia could not be differentiated from parathyroid adenoma; however, parathyroid tumors had slightly longer T1 and T2 times than thyroid nodules or lymph nodes. With further experience, MR tissue characterization may become a useful technique for evaluating neck masses.
Adolescent↗
The use of a flow rate injector for contrast-enhanced computed tomography.
A prototype flow rate injector for intravenous administration of contrast agent was used successfully and without complications in 200 patients undergoing CT of pelvic, abdominal, and mediastinal structures. Improved contrast enhancement was routinely obtained.
Contrast Media↗
Hepatic cirrhosis: magnetic resonance imaging.
The effect of periportal collagen deposition on magnetic resonance images and T1 and T2 relaxation times was studied in the rat. Hepatic cirrhosis was induced in 29 rats by chronic intraperitoneal thioacetamide injections. Another 14 rats in which liver abnormalities did not develop were used as controls. The rats were imaged using a small-bore resistive magnet. Histologic correlations and hydroxyproline measurements were performed to document the changes in periportal collagen deposition. The T1 and T2 relaxation times, determined both in vivo and in vitro with spectroscopy, were compared between the normal group and the group with moderate to severe histologic evidence of cirrhosis. The deposition of two to four times the normal amount of collagen in the liver did not affect the T1 or T2 relaxation time. Relatively pure periportal collagen fibrosis does not appear to affect the magnetic resonance image or T1 or T2 relaxation times of the rat liver.
Animals↗